| Bradley Upshaw Od Inc | |
|
671 Parker Ave, Rodeo, CA 94572-1434 | |
| (510) 799-4258 | |
| (510) 799-6616 |
| Full Name | Bradley Upshaw Od Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 671 Parker Ave, Rodeo, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821206020 | NPI | - | NPPES |
| 11228T | Other | CA | OPTOMETRIC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 11228 (California) | Primary |
| Provider Name | Karen Kopiko |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629005939 PECOS PAC ID: 5698780351 Enrollment ID: I20060216000276 |
| Provider Name | Bradley Upshaw |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992731335 PECOS PAC ID: 2163437930 Enrollment ID: I20090112000498 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Upshaw Od Inc 671 Parker Ave, Rodeo, CA 94572-1434 Ph: (510) 799-4258 | Bradley Upshaw Od Inc 671 Parker Ave, Rodeo, CA 94572-1434 Ph: (510) 799-4258 |
Dr. Karen Kopiko, O.D., F.A.A.O. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 671 Parker Ave, Rodeo, CA 94572 Phone: 510-799-4258 Fax: 510-799-6616 | |
Dr. Bradley George Upshaw, O.D. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 671 Parker Ave, Rodeo, CA 94572 Phone: 510-799-4258 Fax: 510-799-6616 |